Athens Insomnia Scale and PolySomnoGraphy:

a pilot study in RNs working rotating shift system

Anna Korompeli • Alexandra Gavala • Niki Laiou • Eleni Vlachou • Adamantia Savvopoulou • Georgios Fildissis • Pavlos Myrianthefs • Georgios Baltopoulos
University of Athens, Faculty of Nursing, Greece; akorompe76@gmail.com

Background
RN nurses who are routinely work rotating shifts are exposed to sleepiness which
can lead to acute insomnia.

Aim
Aim of the study was to describe sleep characteristics in RNs working rotating shift
system, and to compare night sleep, (between afternoon-morning shift) versus day
sleep (after night shift). Also, to examine if RNs suffer from acute insomnia.

Methods
10 female RNs, between 26-37 years old (mean age= 29.8±2.2), working in an
ICU department rotating shift system participated in the study. The participants
underwent traditional PSG after night shift (day sleep) and between afternoon-
morning shift (night sleep). Also, completed the Athens Insomnia Scale (AIS)
after a week (7 days) of working rotating shifts. The participants worked three
shift system with no particular sequence of rotation and were free from any
medical history. The night sleep between afternoon- morning shift was of the
same duration (00.30 lights off-6.30 lights on) for all the participants. The RNs
after the end of the afternoon shift underwent Polysomnography and in the
morning had the obligation to go to work. The participants were allowed to
sleep as much as they wanted after the night shift.

Results
Day sleep was characterised by more Sleep Efficiency, more SWS, less REM,
less REM latency compared to night sleep. Also, RNs had no evidence of acute
insomnia (AIS=4.4±1.4) (Table1).
Day sleep Night sleep Insomnia Scale
(mean±SD) (mean±SD) (AIS)

Total sleep time (TST) (min) 208.8±8.3 279±3.7 p <0 .05

Sleep efficiency (%) 96.1±1.2 93.9±1.9 p < 0.05

REM latency (min) 68.5±3.2 98.1±2.9 p < 0.05

Stage 1(%) 5.8.0±2.3 8.3±1.2 NS

Stage 2(%) 45.8±1.4 46.8±1.6 NS

SWS(%) 28.1±2.9 21.3±1.2 NS

REM(%) 20.2±1.3 22.9±1.7 p < 0.05

Conclusions
Although according to bibliography, night sleep is more effective, in our study
is proven the opposite. According to our results, day sleep is more efficient, is
characterized by more SWS sleep, despite the fact of less duration. One explanation
would be that night sleep was ‘compressed’, as RNs had to wake up in particular
time. Another explanation would be that the effect of sleeping in a sleep laboratory
can result in an inaccurate representation of the partcipant’s sleep, exaggerating sleep
difficulties-the classic ‘’first night effect’’. Finally, RNs had no signs of acute insomnia,
Design Yannis Yannoulis

as Athens Insomnia Scale (AIS) was scored <6.